KDS Beauty and Wellness School Intake Application

    General Questions:

    Personal Information:

    Gender :
    MaleFemaleOther

    Birthday :

    Application Specific Questions:

    How important would you rate these areas of your life to be? Circle the number that best reflects the importance to you- 1 being the lowest importance and 10 being the highest:

    Health Specific Questions:


    Do you have any medical conditions that might restrict your full participation in this
    program? Please also list any physical limitations that may prevent your full participation.

    YesNo

    Emergency Contact: